Provider Demographics
NPI:1679798995
Name:KAAKO, AHMAD (MD, MBA, FACP)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:
Last Name:KAAKO
Suffix:
Gender:M
Credentials:MD, MBA, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4100
Mailing Address - Country:US
Mailing Address - Phone:479-314-5175
Mailing Address - Fax:
Practice Address - Street 1:3019 BRIGHTON PT
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5477
Practice Address - Country:US
Practice Address - Phone:833-866-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6598207Q00000X, 207R00000X
GA64640207R00000X
OK33174207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program